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Hails KA, McWhirter AC, Sileci ACB, Stormshak EA. Adolescent-onset cannabis use and parenting young children: an investigation of differential effectiveness of a digital parenting intervention. FRONTIERS IN CHILD AND ADOLESCENT PSYCHIATRY 2024; 3:1392541. [PMID: 38938592 PMCID: PMC11210799 DOI: 10.3389/frcha.2024.1392541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Introduction There is scant empirical work on associations between current and past cannabis use and parenting skills in parents of young children. As recreational cannabis use is now legal in nearly half of states in the U.S., cannabis use is becoming more ubiquitous. Methods In the current study, parents of toddler and pre-school age children were randomly assigned to participate in an app-based parenting skills program that included telehealth coaching (Family Check-Up Online; FCU-O), with a focus on parenting in the context of substance use. We aimed to test associations between adolescent-onset and current cannabis use and parent mental health and parenting skills, as well as whether effects of the FCU-O on parent mental health outcomes varied as a function of past cannabis use. Participants were 356 parents of children ages 1.5-5 participating in a randomized controlled trial of the FCU-O. Parents screened into the study if they reported current or past substance misuse or current depressive symptoms. After completing a baseline assessment, parents were randomly assigned to the FCU-O or control group and completed a follow-up assessment 3 months later. Parents retrospectively reported on the age when they initially used substances, as well as their current use. Results After accounting for current cannabis use, adolescent-onset cannabis use was significantly associated with higher symptoms of anxiety and depression, but not with parenting skills. Adolescent-onset cannabis use was found to significantly moderate the effect of the FCU-O on parents' anxiety symptoms. Specifically, the FCU-O was particularly effective in reducing anxiety symptoms for parents with adolescent-onset regular cannabis use, after accounting for current cannabis use. Discussion Adolescent-onset regular cannabis use may be a risk factor for later mental health challenges in parents of children under 5. An app-based parenting intervention may be particularly helpful in reducing symptoms of anxiety for parents who used cannabis regularly as adolescents. The findings have significant implications for the prevention of multigenerational risk for substance use and mental health challenges.
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Affiliation(s)
- Katherine A. Hails
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | | | - Audrey C. B. Sileci
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Davis JP, Pedersen ER, Tucker JS, Prindle J, Dunbar MS, Rodriguez A, Seelam R, D'Amico EJ. Directional associations between cannabis use and anxiety symptoms from late adolescence through young adulthood. Drug Alcohol Depend 2022; 241:109704. [PMID: 36434880 PMCID: PMC9810069 DOI: 10.1016/j.drugalcdep.2022.109704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Two major theories aid in explaining the association between anxiety and cannabis use: a symptom-driven pathway (heightened anxiety precedes greater cannabis use) and a substance-induced pathway (greater use precedes heightened anxiety). Although the co-occurrence of cannabis use and anxiety symptomology is well-established, less is known about the temporal sequence of cannabis use and anxiety symptomology over the course of young adult development METHODS: Data are from an ongoing, longitudinal, cohort study. All prospective analyses used data from wave 8, when participants were between the ages of 17 and 20, through wave 13, when participants are between ages 21 and 24 (N = 2995). Data were set up in accelerated longitudinal design in which we estimated a series of latent difference score models between anxiety and cannabis use from 17 to 24 years old. Models were estimated for men and women, separately. RESULTS For the overall sample and men, greater cannabis use predicted greater subsequent increases in anxiety; however, greater anxiety symptoms were associated with decreasing cannabis use. For women, results were more complex. A positive association was noted between prior, trait-like levels of anxiety predicting greater change (increasing) in anxiety symptomology. However, when change is predicted by prior change we see that cannabis use decreases among women who have recently experienced an increase in anxiety CONCLUSION: The nuanced set of results from this study support a dynamic interplay between anxiety symptoms and cannabis use, with important sex differences observed. Overall, our results pave the way for rethinking our guiding theories to include a more robust, flexible, and dynamic model for understanding associations between substance use and mental health symptomology during a key period of development.
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Affiliation(s)
- Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, USA.
| | - Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | | | - John Prindle
- University of Southern California, Suzanne Dworak-Peck School of Social Work, USA
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Do schizotypy features predict cannabis problems in partnered community adults? Addict Behav 2021; 116:106819. [PMID: 33465724 DOI: 10.1016/j.addbeh.2021.106819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 12/12/2020] [Accepted: 01/04/2021] [Indexed: 11/22/2022]
Abstract
Schizotypy and its associated features-negative schizotypy, disorganization, and positive schizotypy-are correlated with increased cannabis use. Yet, it is unclear whether cannabis users with schizotypy are at greater risk of developing cannabis problems. Individuals with elevated schizotypy may be particularly vulnerable to cannabis problems. It is important to understand this association given the unknown harms of chronic cannabis use. Data for these analyses were drawn from a larger investigation of cannabis use in adult romantic relationships. Participants were community adults (N = 366; M Age = 24.6, SD = 3.1) who reported regular use of cannabis. Participants completed baseline surveys measuring cannabis use frequency, problems, and schizotypy. Follow-up assessments of cannabis problems and frequency were completed 4-, 7- and 10-months post-baseline. Multiple regression was used to test the effect of schizotypy-measured using the Schizotypal Personality Questionnaire-Brief (SPQ-B, Raine & Benishay, 1995)-on cannabis use problems controlling for 30-day cannabis use. At baseline, disorganization and positive schizotypy were associated with cannabis use, primarily for women. Results revealed that with cannabis use frequency in the model, the Disorganization subscale of the SPQ-B predicted cannabis problems at baseline and all 3 follow-up assessments. Results are consistent with research suggesting that those exhibiting odd behaviors report more problematic cannabis use. Future research may further this line of inquiry with a focus on longitudinal, reciprocal relationships among schizotypy features, cannabis use, and cannabis problems.
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Hillmer A, Chawar C, Sanger S, D'Elia A, Butt M, Kapoor R, Kapczinski F, Pare G, Thabane L, Samaan Z. Genetic determinants of cannabis use: a systematic review protocol. Syst Rev 2020; 9:190. [PMID: 32819433 PMCID: PMC7441561 DOI: 10.1186/s13643-020-01442-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the legalization of cannabis in Canada, there is an increase trend in use. Cannabis has been known to have several health implications, one of which is the development of cannabis use disorder (CUD). CUD is more common in males than females, as well as in certain ethnic groups such as Native Americans. Additionally, both environmental and genetic risk factors have been found for cannabis use. The objective of this systematic review will be to summarize the genetic variants associated with cannabis use which have reached borderline genome-wide significance. METHODS This systematic review will incorporate articles that have performed a genome-wide association study (GWAS) investigating cannabis use. MEDLINE, Web of Science, EMBASE, GWAS Catalog, GWAS Central, and NIH Database of Genotype and Phenotype will be searched using a comprehensive search strategy. The quality of genetic association studies (Q-Genie) tool will be utilized to assess the quality of the included studies. All screening and data extraction will occur independently by two authors. If feasible, a random-effects meta-analysis will be conducted on pooled odds ratios of single nucleotide polymorphisms reaching borderline genome-wide significance. DISCUSSION This systematic review will synthesize available GWAS on cannabis use. Results from this review will inform and direct further investigation of genetic variants associated with cannabis use. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020176016.
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Affiliation(s)
- Alannah Hillmer
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON, L8N 3 K7, Canada
| | - Caroul Chawar
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON, L8N 3 K7, Canada
| | - Stephanie Sanger
- Health Science Library, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4 L8, Canada
| | - Alessia D'Elia
- Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON, L8N 3 K7, Canada
| | - Mehreen Butt
- Integrated Science Program, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4 L8, Canada
| | - Raveena Kapoor
- Health Sciences Program, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4 L8, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON, L8N 3 K7, Canada
| | - Guillaume Pare
- Population Health Research Institute, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4 L8, Canada
| | - Lehana Thabane
- Department of Health Research Method, Evidence & Impact, 1280 Main St. W, Hamilton, ON, L8S 4 L8, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th St., Hamilton, ON, L8N 3 K7, Canada.
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Matheson J, Sproule B, Di Ciano P, Fares A, Le Foll B, Mann RE, Brands B. Sex differences in the acute effects of smoked cannabis: evidence from a human laboratory study of young adults. Psychopharmacology (Berl) 2020; 237:305-316. [PMID: 31637452 DOI: 10.1007/s00213-019-05369-y] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/22/2019] [Indexed: 02/01/2023]
Abstract
RATIONALE Animal studies have found robust sex differences in the pharmacokinetics and pharmacodynamics of Δ9-tetrahydrocannabinol (THC). However, the human evidence remains equivocal, despite findings that women may experience more severe consequences of cannabis use than men. OBJECTIVES The objective of this secondary analysis was to examine sex differences in THC pharmacokinetics and in acute subjective, physiological, and cognitive effects of smoked cannabis in a sample of regular cannabis users (use 1-4 days per week) aged 19-25 years. METHODS Ninety-one healthy young adults were randomized to receive active (12.5% THC; 17 females, 43 males) or placebo (< 0.1% THC; 9 females, 21 males) cannabis using a 2:1 allocation ratio. Blood samples to quantify concentrations of THC, 11-OH-THC, and 11-Nor-carboxy-THC (THC-COOH), as well as measures of subjective drug effects, vital signs, and cognition were collected over a period of 6 h following ad libitum smoking of a 750-mg cannabis cigarette. RESULTS Females smoked less of the cannabis cigarette than males (p = 0.008) and had a lower peak concentration of THC and THC-COOH than males (p ≤ 0.01). Blood THC concentrations remained lower in females even when adjusting for differences in estimated dose of THC inhaled. There was very little evidence of sex differences in visual analog scale (VAS) ratings of subjective drug effects, mood, heart rate, blood pressure, or cognitive effects of cannabis. CONCLUSIONS Females experienced the same acute effects of smoked cannabis as males at a lower observed dose, highlighting the need for more research on sex differences in the pharmacology of THC, especially when administered by routes in which titrating to the desired effect is more difficult (e.g., cannabis edibles).
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Affiliation(s)
- Justin Matheson
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada.
| | - Beth Sproule
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, M5S 3M2, Canada
- Pharmacy Department, Centre for Addiction and Mental Health, 1001 Queen Street, Toronto, Ontario, M6J 1H4, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Patricia Di Ciano
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Andrew Fares
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario, M5G 1V7, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
| | - Bruna Brands
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 3H7, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
- Controlled Substances Directorate, Health Canada, Ottawa, Ontario, Canada
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Ortiz-Medina MB, Perea M, Torales J, Ventriglio A, Vitrani G, Aguilar L, Roncero C. Cannabis consumption and psychosis or schizophrenia development. Int J Soc Psychiatry 2018; 64:690-704. [PMID: 30442059 DOI: 10.1177/0020764018801690] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: Cannabis consumption produces psychopathology, in some cases psychotic episodes, which are of our interest in this work. However, the relationship between cannabis use and psychosis has not been fully elucidated. The objectives of this work are to (1) review the current state of knowledge on the association of cannabis use with the risk of the development of psychosis or psychotic symptoms in people without schizophrenia and (2) assess the consistency of the hypothesis that cannabis use is associated with increased risk of psychosis in people without schizophrenia. METHOD: This work included research done in humans until May 2018 with the keywords 'cannabis' and 'psychosis', published in English and Spanish, in the PubMed database. RESULTS: In all, 66 papers were analyzed, of which 23 were cohort trials and 43 were reviews. CONCLUSION: Cannabis use doubles the risk of developing psychosis in vulnerable people. There even exists a relationship regarding the dose used and the age of first use. Gene-environment interactions that modulate the association between cannabis use and the presence of psychosis have also been described.
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Affiliation(s)
- María Bettina Ortiz-Medina
- 1 Area of Research, Department of Medical Psychology, Faculty of Medical Sciences, National University Asuncion, San Lorenzo, Paraguay.,2 Hospital de Clínicas, Faculty of Medical Sciences, National University of Asuncion, San Lorenzo, Paraguay
| | - Marta Perea
- 3 Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency of Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,4 Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Bellaterra, Spain
| | - Julio Torales
- 2 Hospital de Clínicas, Faculty of Medical Sciences, National University of Asuncion, San Lorenzo, Paraguay.,5 Department of Psychiatry, Faculty of Medical Sciences, National University of Asuncion, San Lorenzo, Paraguay
| | - Antonio Ventriglio
- 6 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanna Vitrani
- 6 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lourdes Aguilar
- 7 Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,8 Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain
| | - Carlos Roncero
- 3 Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency of Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,7 Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,8 Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain
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Zielinski L, Bhatt M, Sanger N, Plater C, Worster A, Varenbut M, Daiter J, Pare G, Marsh DC, Desai D, MacKillop J, Steiner M, McDermid Vaz S, Thabane L, Samaan Z. Association between cannabis use and methadone maintenance treatment outcomes: an investigation into sex differences. Biol Sex Differ 2017; 8:8. [PMID: 28367308 PMCID: PMC5372283 DOI: 10.1186/s13293-017-0130-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 03/07/2017] [Indexed: 12/29/2022] Open
Abstract
Background Cannabis will soon become legalized in Canada, and it is currently unclear how this will impact public health. Methadone maintenance treatment (MMT) is the most common pharmacological treatment for opioid use disorder (OUD), and despite its documented effectiveness, a large number of patients respond poorly and experience relapse to illicit opioids. Some studies implicate cannabis use as a risk factor for poor MMT response. Although it is well established that substance-use behaviors differ by sex, few of these studies have considered sex as a potential moderator. The current study aims to investigate sex differences in the association between cannabis use and illicit opioid use in a cohort of MMT patients. Methods This multicentre study recruited participants on MMT for OUD from Canadian Addiction Treatment Centre sites in Ontario, Canada. Sex differences in the association between any cannabis use and illicit opioid use were investigated using multivariable logistic regression. A secondary analysis was conducted to investigate the association with heaviness of cannabis use. Results The study included 414 men and 363 women with OUD receiving MMT. Cannabis use was significantly associated with illicit opioid use in women only (OR = 1.82, 95% CI 1.18, 2.82, p = 0.007). Heaviness of cannabis use was not associated with illicit opioid use in men or women. Conclusions This is the largest study to date examining the association between cannabis use and illicit opioid use. Cannabis use may be a sex-specific predictor of poor response to MMT, such that women are more likely to use illicit opioids if they also use cannabis during treatment. Women may show improved treatment outcomes if cannabis use is addressed during MMT.
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Affiliation(s)
- Laura Zielinski
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada
| | - Meha Bhatt
- Health Research Methodology Graduate Program, McMaster University, Hamilton, ON Canada
| | - Nitika Sanger
- Medical Science Graduate Program, McMaster University, Hamilton, ON Canada
| | - Carolyn Plater
- Canadian Addiction Treatment Centres, Hamilton, ON Canada
| | - Andrew Worster
- Canadian Addiction Treatment Centres, Hamilton, ON Canada.,Department of Medicine, McMaster University, Hamilton, ON Canada
| | | | - Jeff Daiter
- Canadian Addiction Treatment Centres, Hamilton, ON Canada
| | - Guillaume Pare
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - David C Marsh
- Canadian Addiction Treatment Centres, Hamilton, ON Canada.,Northern Ontario School of Medicine, Sudbury, ON Canada
| | - Dipika Desai
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON Canada
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
| | - Meir Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada.,Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON Canada
| | - Stephanie McDermid Vaz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Cleghorn Early Intervention Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
| | - Lehana Thabane
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada.,Biostatistics Unit, Research Institute at St Joes, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
| | - Zainab Samaan
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada.,Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON Canada
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Danielsson AK, Lundin A, Allebeck P, Agardh E. Cannabis use and psychological distress: An 8-year prospective population-based study among Swedish men and women. Addict Behav 2016; 59:18-23. [PMID: 27010850 DOI: 10.1016/j.addbeh.2016.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/01/2016] [Accepted: 03/14/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Previous studies have reported positive associations between cannabis use and mental health problems. However, it has not been possible to draw a definitive conclusion regarding the causal direction between cannabis use and impaired mental health. This study aimed at examining possible associations between cannabis use and psychological distress (as measured by the General Health Questionnaire, GHQ-12) in men and women respectively, using both measures as both exposure and outcome. METHODS Data were obtained from a cohort study (the Stockholm Public Health Cohort) with an 8-year follow-up in the general population in Stockholm County, Sweden. The study sample comprised 19,327 men and women, aged 18-84years, who answered surveys in 2002 and 2010. RESULTS Cannabis use was associated with increased odds ratios (OR) for psychological distress in women at 8-year follow-up, with OR=1.37 [1.1-1.7, 95% CI], but not in men; OR=1.14 [0.9-1.5, 95% CI]. In women, this association remained when adjusted for potential confounders (tobacco smoking, alcohol consumption, socioeconomic position (SEP) and unemployment); OR=1.27 [1.0-1.6, 95% CI]. Moreover, women reporting psychological distress at baseline had an increased risk of cannabis use at follow-up; OR=1.40 [1.1-1.8 95% CI]. However, this association was no longer statistically significant when adjustments were made for baseline cannabis use, OR=1.10 [0.8-1.5, 95% CI]. CONCLUSIONS This study revealed that, in women, cannabis use was associated with an increased risk of psychological distress eight years later. Optimal interventions to identify these women seem warranted.
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Danielsson AK, Lundin A, Agardh E, Allebeck P, Forsell Y. Cannabis use, depression and anxiety: A 3-year prospective population-based study. J Affect Disord 2016; 193:103-8. [PMID: 26773900 DOI: 10.1016/j.jad.2015.12.045] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/10/2015] [Accepted: 12/26/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Whether or not cannabis use may increase the risk for depression and/or anxiety is not clear. For one thing, it has not been possible to draw a definitive conclusion regarding the direction of causality, i.e. whether cannabis use increases the risk for depression/anxiety or vice versa. This study aimed at examining possible associations between cannabis use, depression and anxiety, using all three measures as both exposure and outcome. METHODS Data were obtained from a longitudinal cohort study comprising 8598 Swedish men and women, aged 20-64, with a three-year-follow-up. RESULTS Adjusted for sex and age, cannabis use at baseline was associated with an increased relative risk (RR) for depression and anxiety at follow-up, with RR=1.22 [1.06-1.42 Cl 95%] for depression and RR=1.38 [1.26-1.50 Cl 95%] for anxiety. Adjusted for all confounders (alcohol and illicit drug use, education, family tension, place of upbringing), the associations were no longer statistically significant; RR=0.99 [0.82-1.17 Cl 95%] for depression and RR=1.09 [0.98-1.20 Cl 95%] for anxiety. Age-adjusted, reporting depression or anxiety at baseline increased the risk of cannabis onset at follow-up three years later; RR=1.62 [1.28-2.03 CI 95%] and RR=1.63 [1.28-2.08 CI 95%] respectively. However, adjusted for other illicit drug use the associations were no longer statistically significant. LIMITATIONS Lack of information on frequency of cannabis use and of age of initiation of use. CONCLUSIONS We found no longitudinal associations between cannabis use and incidence of depression/anxiety, or between depression/anxiety and later cannabis use onset.
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Affiliation(s)
- Anna-Karin Danielsson
- Karolinska Institutet, Department of Public Health Sciences, SE-171 77, Stockholm, Sweden.
| | - Andreas Lundin
- Karolinska Institutet, Department of Public Health Sciences, SE-171 77, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Emilie Agardh
- Karolinska Institutet, Department of Public Health Sciences, SE-171 77, Stockholm, Sweden
| | - Peter Allebeck
- Karolinska Institutet, Department of Public Health Sciences, SE-171 77, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Yvonne Forsell
- Karolinska Institutet, Department of Public Health Sciences, SE-171 77, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
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